Work organization and Low back pain in nursing personnel

Nursing personnel are at a high risk from occupational low back injury. Work organization has been suggested as one factor playing a part in the aetiology of occupational low back pain. Baseline data for a prospective epidemiology study were gathered by means of a questionnaire. One part of the questionnaire elicited characteristics of work organization, perceived autonomy, the relationship with head nurse and satisfaction in the relationship with co-workers. Information on history of musculoskeletal problems, reported frequency of lifting and personal characteristics was also gathered. Of 787 nursing staff at two acute care hospitals, 154 (19-6%) reported troublesome low back pain occurring within the previous 6 months. From univariate analyses, such characteristics of work organization as shift, type of schedule and primary versus functional nursing were not associated with low back pain. The relationship with head nurse and perceived autonomy of the job also were not related to recent back pain. Recent low back pain was significantly associated with younger age, the job category ‘registered nurse’ and greater satisfaction in relationships with co-workers. These associations were confirmed in multivariate analysis. None of the work organization factors examined, with the exception of satisfaction with co-workers, were associated with back pain in this study. Moreover, the positive association of satisfaction with coworkers suggests that interventions to improve working relationships may not be helpful in prevention programmes. To some extent, these results are susceptible to biases resulting from selective attrition from nursing and selective participation in the study.     

Can we simulate the biomechanical effects of exoskeletons prior to workstation implementation? Application of the Forces ergonomic method

Increasingly, exoskeletons are becoming a valuable tool for prevention technicians to promote occupational health and reduce the risk of musculoskeletal disorders in industry. However, the effective implementation of industrial exoskeletons is a complex challenge. Deciding whether these devices are the optimal solution to the detected ergonomic risks at a specific workstation is not straightforward. This study presents the modelling of three commercial passive exoskeletons, one for lumbar and two for shoulder risk reduction, to be considered in the musculoskeletal risk assessment of industrial workstations. The presented modelling considers the forces and moments applied by exoskeletons to the body using the Forces ergonomic method, providing the musculoskeletal risk for each joint based on inertial motion capture data registered at each workstation. This approach is exemplified on simulated and actual production workstations. The results reveal that the modelling application allows an objective understanding of the biomechanical effects of exoskeletons. Modelling establishes a predictive tool to assess and make decisions regarding the suitability of the exoskeleton prior to implementation at a workstation.     

FOUR APPROACHES TO THE STUDY OF AGEING IN INDUSTRY

Accurate reporting of work-related conditions is necessary to monitor workplace health and safety, and to identify the interventions that are most needed. Reporting systems may be designed primarily for external agencies (OSHA or workers' compensation) or for the employer's own use. Under-reporting of workplace injuries and illnesses is common due to a variety of causes and influences. Based on previous reports, the authors were especially interested in the role of safety incentive programmes on under-reporting. Safety incentive programmes typically reward supervisors and employees for reducing workplace injury rates, and thus may unintentionally inhibit proper reporting. The authors describe a case study of several industrial facilities in order to illustrate the extent of under-reporting and the reasons for its occurrence. A questionnaire and interview survey was administered to 110 workers performing similar tasks and several managers, health, and safety personnel at each of three industrial facilities. Although less than 5% of workers had officially reported a work-related injury or illness during the past year, over 85% experienced work-related symptoms, 50% had persistent work-related problems, and 30% reported either lost time from work or work restrictions because of their ailment. Workers described several reasons for not reporting their injuries, including fear of reprisal, a belief that pain was an ordinary consequence of work activity or ageing, lack of management responsiveness after prior reports, and a desire not to lose their usual job. Interviews with management representatives revealed administrative and other barriers to reporting, stemming from their desire to attain a goal of no reported injuries, and misconceptions about requirements for recordability. The corporate and facility safety incentives appeared to have an indirect, but significant negative influence on the proper reporting of workplace injuries by workers. A variety of influences may contribute to under-reporting; because of under-reporting, worker surveys and symptom reports may provide more valuable and timely information on risks than recordable injury logs. Safety incentive programmes should be carefully designed to ensure that they provide a stimulus for safety-related changes, and to discourage under-reporting. A case-control study of similar establishments, or data before and after instituting safety incentives, would be required to more clearly establish the role of these programmes in under-reporting.     

From industrial safety to corporate health management

Occupational health and safety is one of the most important topics of ergonomics. In many countries the practical issues are addressed in worker protection laws or rules and most companies have some sort of occupational health and safety system. As with many other ergonomics approaches, such activities are often necessary because of legal requirements. Such efforts are often viewed by management as primarily cost intensive. To change this image, it would be helpful to have a more positive, management-oriented approach. Corporate health management as a module of an integrated management system can fulfil this goal.     

The effects of occupational interventions on reduction of musculoskeletal symptoms in the nursing profession

The objective of the review was to gain more insight into the effects of occupational interventions for primary prevention of musculoskeletal symptoms in healthcare workers. The Cochrane Collaboration methodological guidelines for systematic reviews functioned as a starting point. Thirteen studies meeting the inclusion criteria were analysed for methodological quality and effects. Eight outcome effect areas were established and defined as areas in which an effect had been determined in at least two studies. A method based on levels of scientific evidence was then used to synthesize the information available. Strong scientific evidence for the beneficial effect of occupational interventions was found for the outcome effect areas physical discomfort, technical performance of transfers and frequency of manual lifting. Insufficient evidence was found for the effect areas absenteeism due to musculoskeletal problems, musculoskeletal symptoms, fatigue, perceived physical load and knowledge of risk factors at work and ergonomic principles. Training and education combined with an ergonomic intervention were found to be effective.     

Cost effectiveness of ergonomic redesign of electronic motherboard

A case study to illustrate the cost effectiveness of ergonomic redesign of electronic motherboard was presented. The factory was running at a loss due to the high costs of rejects and poor quality and productivity. Subjective assessments and direct observations were made on the factory. Investigation revealed that due to motherboard design errors, the machine had difficulty in placing integrated circuits onto the pads, the operators had much difficulty in manual soldering certain components and much unproductive manual cleaning (MC) was required. Consequently, there were high rejects and occupational health and safety (OHS) problems, such as, boredom and work discomfort. Also, much labour and machine costs were spent on repairs. The motherboard was redesigned to correct the design errors, to allow more components to be machine soldered and to reduce MC. This eliminated rejects, reduced repairs, saved US dollars 581495/year and improved operators' OHS. The customer also saved US dollars 142105/year on loss of business.     

Modification of work organization

In modern Swedish industry it has been increasingly possible to reduce the dangers to health from such traditional work environmental factors as heavy lifting, loud noise, and hazardous chemicals. There has, instead, been a relative increase in the significant effects of work organization on the occurrence of injury and illness. Changes in work organization must be carried out on the basis of detailed knowledge of the work process, the tools and the product. Changes in work organization must also take into account how the personnel involved experience the way in which their needs are respected and satisfied at work. In Sweden, the work safety committees composed of representatives of all parties involved have the task not only of leading safety work, but also of channelling the needs of individual workers to influence work organization in so far as this can be of significance for their well-being and health. Company health care can analyse the common experience of a group of workers concerning their work situation in this broader context. A working method will be presented.     

Understanding workplace violence: The value of a systems perspective

Workplace violence is a leading form of occupational injury and fatality, but has received little attention from the ergonomics research community. The paper reports findings from the 2012 New Zealand Workplace Violence Survey, and examines the workplace violence experience of 86 New Zealand organisations and the perceptions of occupational health and safety professionals from a systems perspective. Over 50% of respondents reported violence cases in their organisation, with perpetrators evenly split between co-workers and external sources such as patients. Highest reported levels of violence were observed for agriculture, forestry and construction sectors. Highest risk factor ratings were reported for interpersonal and organisational factors, notably interpersonal communication, time pressure and workloads, with lowest ratings for environmental factors. A range of violence prevention measures were reported, although most organisations relied on single control measures, suggesting unmanaged violence risks were common among the sample.     

Exposure to and effects of glare from high mast lighting on workers at a timber terminal

High mast floodlighting at outdoor workplaces has economic advantages but suffers from shortcomings such as glare. This study was made to collect and evaluate data from a situation with glare from a physical and occupational health standpoint. When unloading timber, the worker's gaze is frequently directed upward, whereas conventional glare indexes for luminaires assume the gaze is diagonally downwards. It was found that reduced visual acuity could cause difficulty in normal working routines.     

Targeting ergonomics interventions--learning from health promotion

Ergonomics often involves encouraging people to accept change, a process affected by their knowledge, attitudes and beliefs. This paper argues that ergonomics projects are likely to have greater success where formal account is taken of these characteristics, and interventions are tailored accordingly. Furthermore, it is suggested that ergonomics can usefully draw upon behaviour change models developed by those concerned with health promotion in the community. One influential model is Prochaska and DiClemente's (Psychotherapy: Theory, Research and Practice, 19, 276-288, 1982) stage of change framework, which describes recipients of health information as progressing through six stages towards stable healthy behaviour: precontemplation, contemplation, preparation, action, maintenance and relapse. This recognises the dynamic nature of behaviour change and that, both within and between individuals, responses may vary from failing to acknowledge existence of a health risk, to where something has already been done about it. Proponents of the model contend that interventions should seek to identify recipients' stage of change and target information and advice accordingly. It is proposed that Prochaska and DiClemente's approach might usefully inform ergonomics activities, particularly when advising with respect to health and safety (e.g. manual handling, upper limb disorders, fall risk, plant safety, etc.) but perhaps also where dealing with other ergonomics considerations (i.e. comfort and performance).     

Worker productivity, and occupational health and safety issues in selected industries

The main objective of this research was to identify factors that affected worker productivity, occupational health and safety in selected industries in a developing country. Fifty production managers participated in the study. Fifty-four percent of the managers reported hot environmental conditions, 28% a noisy environment, and 26% a lack of resources and facilities. Managers received worker complaints of fatigue, back pain, upper-body pain, hand and wrist pain and headaches. Management (88%) acknowledged not having knowledge or access to ergonomics information. Ninety-four percent of the companies did not carry out ergonomic assessments. A significant correlation (p<0.01) was found among productivity indicators and health and organizational attributes. Lack of skills in ergonomics and training, communication and resources are believed to be some of the factors contributing to the poor ergonomic conditions and consequent loss of worker productivity and reduced health and safety in these industries.     

Summary and prospects: occupational health and safety

Abstract

This summary covers three conference sessions on occupational health and safety, of which six papers are included in this issue of Ergonomics. Based on these sessions we will comment on the role of ergonomics programmes in occupational health and safety in industry. The summary is divided into the following topics: goal, international aspects, epidemiology, team consideration, problem analysis, development of solutions, implementation and evaluation.     

Changing the speed of shift rotation: a field study

Abstract

A group of 33 controllers of an emergency service were studied before and after a change in shift roster. The original roster was the traditional weekly rotating type of three shifts, morning, afternoon and night in that direction, in which controllers worked seven consecutive shifts of the same type. This was changed to a rapidly rotating roster of shifts with no more than three consecutive night shifts. The direction of shift change remained the same. Sleep and meal diaries were kept by all controllers for 2 weeks before the roster change. Self-report measures were taken of health, social drug consumption and work variables, an anxiety inventory, the State-Train Anxiety Inventory and the Work Environment Scale were administered both before and 5 months after the roster change. Significant improvements were found after the shift roster change on almost all measures with the exception of self-reported nervousness and loss of appetite and a number of items in the Work Environment Scale. This finding provides some evidence from the field for the argument that rapidly rotating shifts may be the optimal form of shift system.     

Implementation programme of the Swedish ordinance concerning work postures and working movements

Ergonomically-rclated occupational injuries have been increasingly recognized in Sweden. The official injury statistics show that ergonomically-related injuries accounted for about 20% of all reported occupational injuries (ISA 1985). On 1 January 1984 an ordinance concerning work postures and working movements was passed. It was built upon and is a complement to the Work Environment Act of 1978. There are in Sweden about 400 labour inspectors in 19 regional Labour Inspectorates, to ensure among other things that rules concerning the occupational environment are complied with at the workplace level. Sweden has a working population of about 4 million people. To implement the above-mentioned ordinance, a 2-year implementation programme was set up. The labour inspectors first identified major areas with severe non-ergonomic working conditions, in all areas of work. Six typical work situations were then selected and the inspectors were asked to pay special attention to them, and to intensify their efforts on these work situations, during a 10-month period. Eighteen months after the ordinance came into effect, the implementation programme and the labour inspectorate input was evaluated. The preliminary results showed an overall increase in ergonomic awareness. The ordinance was distributed in about 120000 copies, and the labour inspectors found it to be a useful tool in their work. Citations concerning ergonomics had increased considerably during this period.     

The who and the what of usage of two cancer online communities

The explosion of use of Internet-based communication for health requires attention to the ways survivors of specific diseases and those close to them participate in using resources. This research focuses on two cancer groups – breast and prostate – and how they use WebMD asynchronous bulletin boards. Four hundred and eighty two messages were coded for communicator (survivors, spouses, others) and content of messages. Most common communicators were survivors, but the two groups differed in percentages of communicator. Of four main categories of content – medical/treatment, intimacy/sexuality, emotional expression, and support – most common were support and medical/treatment. The groups differed significantly on those four categories, with breast cancer more support-dominated and prostate more medical/treatment-dominated and more intimacy/sexuality messages. There were no group differences in emotional-toned vs. social support seeking vs. providing support, or positive vs. negative emotions expressed. Generally, there was considerable commonality, and the differences found primarily supported gender-specific notions of communication and need.     

绿色电脑

随着电脑的普及,日常生活中越来越多的接触电脑,对电脑的环保要求越来越高,同时人们也在不断地关注使用电脑过程中的健康问题。